Organization
HCA BH LPS MHS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THIET VAN PHAN (MHS)
(714) 834-6843
Entity
Organization
Contact information
Practice address
405 W 5TH ST, SUITE 550, SANTA ANA, CA 92701-4519
(714) 834-4707
Mailing address
11911 WEST ST, GARDEN GROVE, CA 92840-2552
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
09/28/2006
Last updated
08/22/2020
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